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Have You Been a Victim of Pregnancy Discrimination?
We are investigating claims of pregnancy discrimination in the workplace. Please take this brief survey to see if you have a qualifying pregnancy discrimination claim.
8
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1
Were you pregnant while working for your employer in the past year?
*
This field is required.
YES
NO
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2
Did you request accommodations related to your pregnancy?
*
This field is required.
YES
NO
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3
Were you forced to take unpaid leave or fired because of your pregnancy or any restrictions related to your pregnancy?
*
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YES
NO
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4
Which Company(ies) Did You Work For?
*
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5
In What City(ies) and State(s) Did You Work?
*
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6
What is Your Full Name?
*
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First Name
Last Name
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7
What's Your Phone Number?
*
This field is required.
Please enter a valid phone number.
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8
What's Your Email Address?
*
This field is required.
example@example.com
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